The Application Analysis Of NPWT(negative Pressure Wound Therapy) And 3P Treatment Concept In Limbs Refractory Wounds

Objective: To discussion NPWT(negative pressure wound therapy) and 3P wound treatment concept a large area of skin and soft tissue avulsion treatment in the limbs treatment. And by summarizing the law, to achieve clinical limbs large skin and soft tissue avulsion individualized treatment to provide more comprehensive, more reliable and more representative of the theoretical basis. And to explore the NPWT(negative pressure wound therapy) and 3P wound treatment concept in a large area of skin and soft tissue limb avulsion clinical value in the treatment of wounds. Methods: Select from January 2014 to January 2016 were treated 30 cases of lower limb large area of skin and soft tissue avulsion(less than patients with lower limb Mess score 7 points) and by the treatment of a wound patients underwent skin grafting. 15 cases were rows NPWT(negative pressure wound therapy) and 3P(Prepare, Protect, Progress) wound treatment concept cure treatment(experimental group), and another 15 cases were traditional debridement and negative pressure therapy(control group). The experimental group received debridement + VERSAJET ? waterjet systems; wound protecting material using a silver ion Yinkang love dressing manufacturer Smith & Nephew. Experimental and control groups pressure source are used in our hospital center negative, NPWT suction materials are used within the first Wuhan Davis Medical Co., Ltd. provides hydration seaweed salt containing polyvinyl alcohol foam dressing drainage tube. Experimental group: 10 males and 5 females; mean age 42.1(15-56) years; wound range: 2-16% of body surface area(Total Body Surface Area, TBSA). Control group: 12 males, 3 females; mean age 39.6(17-58) years; wound range: 2.5-14%(TBSA). Results: Test group average operative time 1.2 ± 0.2h, the control group, the average operation time 1.0 ± 0.3h, the two groups of patients operative time was statistically significant(P <0.05) by difference; the experimental group after injury to the skin grafting time 8.7 ± 1.9d to skin grafting time 10.5 ± 2.1d, compared to skin grafting time difference was statistically significant(P <0.05) in the control group after two injury after injury; the test group 1 case of fever patients wound reasons, changes in blood two cases postoperative skin graft survival 97.36%, skin graft healing time(8.7 ± 4.5) d, the control group patients had skin grafts after 2 local infection, 5 cases of patients with fever due to wounds reasons, changes in blood six cases. Graft survival rate of 90.5%, skin graft healing time(9.4 ± 5.2) d. Two skin graft survival and graft healing time, the difference was not statistically significant(P> 0.05).Conclusion : NPWT(negative pressure wound therapy) and 3P wound treatment concept in the limbs large area of skin and soft tissue avulsion surgery longer than traditional negative pressure therapy, after injury to the skin grafting treatment time is less than conventional vacuum technology, but postoperative skin graft survival rate and no significant difference in healing time of skin grafting, only that compared with the traditional negative pressure therapy, NPWT and wound treatment 3P philosophy have a greater advantage.